HomeMy WebLinkAbout05-06-13 (2) 1505610105
REV-1500 R(oz.u)(R) ly
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes """"°'"""""°` County Code Year File Number
PO BOX 280601
INHERITANCE TAX RETURN
Harrisburg,PA V128-060i RESIDENT DECEDENT ` 21 f13 X0003
ENTER DECEDENT INFORMATION BELOW
1211312412 4412011918
Decedent's Last Name Suffix Decedent's First Name MI
Smettzer Ruth E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1.Original Return ( D 2.Supplemental Return C= 3. Remainder Return(Date of Death
Prior to 12-13.82)
O 4.Limited Estate p 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12.12.82)
CID 6, Decedent Died Testate O T.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) Ex. A (Attach Copy of Trust.)
O 9,Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death C= 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Peter J. O'Donnell (717)248-3911
RE(STV30F WILL&- SE OgYf'
Do 11 0
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First Line of Address rr7 $ CS CI)--1
n r rr1 T
15 South Wayne Street n z rn o
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Second floe of Address
City or Post Office State ZIP Code �` 7'r7
Lewistown PA 17044 ra
Correspondent's e-mail address:pjolaw @onecommaii.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
It is true,correct and complete.Declaration of preparar other than the Personal representative is based On all information of which preparer has any
E knowledge
Sir:S( ,R k E FgR F /RETcN
a
�i/ DATE
ADOR r
2 Main treet, Mifflintown, PA 17059
$I R OF PR PA ER THAN REPRE N TIVE DA ( j
ADDRESS �-
15 South Wa e Street, Lewistown, PA 17044
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX(Fl)
RECAPITULATION
1. Real Estate(Schedule A). .... .. .... ........... ............... ... ..... 1.
2. Stocks and Bonds(Schedule B) . .. ... .. ........ . ...... ... .. ........ ... 2.
3. Closely Held Corporation,Partnership or Sale-Proprietorship(Schedule C) .. ... 3.
4. Mortgages and Notes Receivable (Schedule D)......... .......... .. ...... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5. 205,557.45
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . .... 6.
7. Inter- rvos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested..... ... 7.
8. Total Gross Assets(total Lines 1 through 7)...... ..... ... . ...... ........ 8. 205,557.45
9. Funeral Expenses and Administrative Costs(Schedule H)..... . .. ... ..... ... 9. 17,057.03
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). . ..... .. ... ... 10. 14,345.89 .
11. Total Deductions total Lines 9 and 10 .... .. ......... ...... .... .. . . .... 11. 31,402.
( ) .92
12. Net Value of Estate(Line 8 minus Line 11). . . ......... ...... .... . . ..... . 12. 174,154.53
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which �
an election to tax has not been made(Schedule J) . ......... . ..... ..... ... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) .......... .......... .. 14. 174,154.53
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 -
(a)(1.2)X.0_
16. Amount of Line 14 taxable
at lineal rate X.0 45 174,154.53 16, 7,836.95
17. Amount of Line 14 taxable "..,.T,� .....:......._, _,_,. .,„......i „._._._..,,. ..- _.>,..,:-._.. .,_.._..,,.-...,._
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE ....... .... ...... .. ... .. .. ............. ....... ... ..... 7,836.95
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
1505610205 1505610205
REV-1500 EX(F0 Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Ruth E. Smeltzer
STREETADDRESS
100 Mount Allen Drive
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
f. Tax Due(Page 2,Line 19) (1) 7,636.95
2. CreditslPayments
A.Prior Payments 7,000.00
B.Discount 366.42_
Total Credits(A+B] (2) 7,366.42
3. Interest
(3)
4. If Line 2 Is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 466.53
Make check payable t0: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred.......................................................................................... ❑ 0
b. retain the right to designate who shalt use the property transferred or its income ............................................ 0 a
c. retain a reversionary interest .............................................................................................................................. ❑ ■
d. receive the promise for life of either payments,benefits or rare?...................................................................... ❑ ■
2, if death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?..............................---........--........................................................... ❑ 0
1 Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. El ■
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ..................................._..,..........................................,....................-............... ❑ E
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
172 P.S.§9116(a)(1.1)(ii)].The statute does not exempts transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
RI'V-1508 EX+(08-u)
L0 1 pennsytvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ruth E. Smeltzer 21-13-0003
Include the proceeds of litigatlon and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 195,492.35 units of Federated Government Obligations Fund IS Principal at$1.00 per unit. 195,492.35
2, Checking Account#1000707 at First National Bank of Pennsylvania,32 East Market Street,Lewistown,
PA 17044. 6,872.70
3, Highmark-premium refund. 109.20
4, Public School Employees Retirement System-retirement benefits for December 2012 and January
2013. 1,083.20
TOTAL(Also enter on Line 5, Recapitulation) $ 205,557.45
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
W 3 pennsylvania SCHEDULE H
0 DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ruth E. Smeltzer 21-13-0003
Decedent's debts must be reported on Schedule I,
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1' Heller-Hoenstine Funeral Homes, Inc.-balance due for funeral services. 194.75
2. Diana Smeltzer-reimbursement for costs advanced for memorial service. 150.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 8,694.00
Name(s)of Personal Representative(s) First National Bank of Mifflintown
Street Address 2 Main Street _
city Mifflintown state PA ZIP 17059
Year(s)Commission Paid: 2013
7,195.00
2. Attorney Fees: Nielsen & O 'Donnell
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation,)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
a. Probate Fees: Glenda Farner Strasbaugh, Register of Wills
393.50
51 Accountant Fees:
6. Tax Return Preparer Fees: H&R Block — 2012 U.S. and Pa. income 139.00
tax returns
7. Glenda Farner Strasbaugh, Register of Wills-1 short certificate 5.00
a. The Sentinel-pubication of Estate Notice. 210.78
9. Cumberland Law Journal-publication of Estate Notice 75.00
TOTAL(Also enter on Line 9, Recapitulation) $ 17,057.03
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
i� pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ruth E. Smeltzer 21-13-0003
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,Including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Alert Pharmacy Services,Inc.-prescription drugs. 117.06
2. Public School Employees Retirement System-reimbursement for retirement benefits not entitled
to after date of death. 848.69
3. Messiah Lifeways at Messiah Village-nursing home room and board. 13,380.14
TOTAL(Also enter on Line 10, Recapitulation) $ 14,345.89
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01.10)
T-jr
g 7pennsylvania SCHEDULE ]
t�7} DEPARTMENT OF REVENUE
tNHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ruth E. Smeltzer 21-13-0003
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(5)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS(include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
I. Suzanne S.Adams,49 Kathryn Drive,New Bloomfield,PA 17068 Daughter 113rd
2. Barbara J. Smeltzer,1400 Kelton Avenue,Apt.108,Los Angeles,CA
90024-5467. Daughter 1/3rd
3, Diana R.Smellzer,373 Stonehedge Lane,Mechanicsburg,PA 17055 Daughter 1/3rd
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE,
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART 11 —ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. Is
If more space is needed,use additional sheets of paper of the same size.
r Y
LAST WILL AND TESTAMENT
I, RUTH B. SMELTZER, now of Cumberland County, Pennsylvania,
intending to dispose of all of my property, make the following to be my Last Will,
revoking all Wills and Testamentary Dispositions heretofore made by me.
ITEM I: I direct that my Executor pay my funeral expenses, the expenses
of the administration of my Estate and my lawful debts.
ITEM IL• If my husband, HAROLD L. SMELTZER, survives me, I give
him all of the tangible personal property which I may own at the time of my death,
including insurance then in effect thereon. If my said husband fails to survive me, then
I give all of the tangible personal property (excluding any motor vehicles) which I may
own at the time of my death, including any insurance then in effect thereon, to my
daughters, DIANA RUTH, BARBARA JEAN and SUZANNE LINDA, or such of
them as survive me, to be divided among them in whatever manner they may agree.
Provided, however, that any items not selected or with respect to which agreement
cannot be reached, shall become part of the residue of my Estate.
ITEM III: All federal and state estate, inheritance and other taxes of the
same nature payable because of my death, including any interest or penalties thereon,
with respect to any property comprising part of my Estate, whether or not the property
passes under this Will or whether the taxes are payable by my Estate or by any recipient
or beneficiary thereof, other than any generation-skipping taxes, shall be paid by my
Executor from the residue of my Estate with no right of reimbursement from the
recipient or beneficiary of any such property.
ITEM IV: If my husband, HAROLD L. SMELTZER, survives me, I give
and devise the residue of my Estate to him. If my said husband fails to survive me, then
I give and devise the residue of my Estate, in equal shares, to such of my daughters,
DIANA RUTH, BARBARA JEAN and SUZANNE LINDA, as survive me. If neither
I
Exhibit A
f
my said husband nor any of my said daughters survive me, then I give and devise the
residue of my Estate to my said husband's niece, LARUE M. SMELTZER MILLER,
and my brother, CARROLL LINCOLN BOUGHTER, in equal shares.
ITEM V: No interest of any beneficiary created herein,whether in
principal or income, shall be subject to the beneficiary's debts, liabilities or legal
process prior to the distribution to such beneficiary, so that my Executor shall not
be required to make any disbursements to any assignees or creditors or otherwise than
to the beneficiaries in person.
ITEM VI: My Executor, for the purpose of administering my Estate,
in addition to the specific powers herein granted and in addition to any authority
given it by law, shall have the authority to exercise any and all of the following
powers:
(a) To sell any real estate which may form part of my Estate,
in such manner, at such times, at such prices and upon such terms of
payment, as it deems for the best interests of my Estate; to give
options for the purchase of any such real estate upon such terms as it
deems for the best interests of my Estate; to manage and make
repairs and improvements to any such real estate, and to lease the
same upon such terms as it deems for the best interests of my Estate.
(b) To sell any property of any kind of my Estate, at such
time and upon such terms as it may deem for the best interests of my
Estate.
(c) To retain,without liability, any property,until such time
as it shall deem it desirable to sell the same.
(d) To invest,reinvest and change investments at its
discretion.
(e) To borrow such moneys as it deems necessary for the
administration of my Estate and the payment of any taxes due
thereon, including any interest and penalties. It shall have complete
authority in connection with such loans to execute and deliver
promissory and judgment notes and bonds, to collateralize the same
with property of my Estate, and to deliver mortgages and bonds on
any real estate.
��= 2
(f) To pay or compromise any obligation or claim, including
taxes, either in favor of or against my Estate, upon such terms as it
determines and upon such evidence as it deems sufficient.
(g) To join in filing joint income tax returns to the extent
permitted by law without requiring my husband to indemnify my
Estate against liability for the income tax payable by virtue of his To
make gifts to my issue, unlimited in amount, for purposes of making
me eligible for medical assistance or other governmental benefits.
income.
ITEM VII: I appoint FIRST NATIONAL BANK OF MIFFLINTOWN,
of Mifflintown, Pennsylvania, or its successor, as Executor of this Will and I direct that
said Executor shall not be required to file bond or furnish surety in any jurisdiction.
IN WITNESS WHEREOF, I, RUTH B. SMELTZER, the Testatrix, have
to this, my LAST WILL AND TESTAMENT, set my hand and seal, this day of
June, 2008. For identification I have signed each page of this Will, which consists of
three (3) pages.
(SEAL)
—iliJU-1 B. SMKLTZER
Signed, sealed, published and declared by the above-named RUTH B. SMELTZER, as
and for her LAST WILL AND TESTAMENT, in the presence of us, who have
hereunto subscribed our names, at her request, as witnesses thereto, in the presence of
the said Testatrix and in the presence of each other.
&k, 3L Mr l/inln4vn�/?Ai '7G5"%
/ itnes Address
Witness Address
3
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
: ss:
COUNTY OF CUMBERLAND
I
We, RUTH B. SMELTZER, UA-AC and
the Testatrix, and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed the
instrument as her Last Will and that she signed willingly or directed another to sign for
her and that she executed it as her free and voluntary act for the purposes therein
expressed; and that each of the witnesses, in the presence and hearing of the Testatrix,
signed the Will as witnesses and that to the best of their knowledge, the Testatrix was at
least 18 or more years of age, of sound mind and under no constraint or undue
influence.
Witness ✓RUTH B. SMELTZER
Witness
Subscribed, sworn to and acknowledged before me by RUTH B. SMELTZER, the
Testatrix, and subscribed and sworn to before me by K"4& Q Q a,Y/'<- and
witnesses, this \k4—day 6f June, 2008.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Sharon L.Webler,Si Public
MlMintown Som,Juniata county
My Commission Expires Feb.2,2012
Member,Pennsylvania Association of Notaries
t
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